Literature- and Experience-Based Consensus for Acute Post-operative Endophthalmitis and Endogenous Endophthalmitis in Taiwan

doi:10.1007/s40123-023-00835-5

. 2024 Jan;13(1):1-19.

doi: 10.1007/s40123-023-00835-5. Epub 2023 Nov 7.

Literature- and Experience-Based Consensus for Acute Post-operative Endophthalmitis and Endogenous Endophthalmitis in Taiwan

Cheng-Yung Lee^{1

2

3}, Shwu-Jiuan Sheu^{4

5}, San-Ni Chen^{6

7}, Cheng-Kuo Cheng^{8

9}, Hsi-Kung Kuo¹⁰, De-Kuang Hwang^{11

12}, Chien-Hsiung Lai^{13

14

15

16}, Wei-Chun Chan¹⁷, Yi-Ting Hsieh^{2

3}, Chang-Hao Yang^{18

19}

Affiliations

¹ Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Hospital, No. 25, Ln. 442, Sec. 1, Jingguo Road, North District, Hsinchu City, 300, Taiwan (ROC).
² Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City, 100225, Taiwan (ROC).
³ Department of Ophthalmology, National Taiwan University College of Medicine, No. 1 Jen-Ai Road Section 1, Taipei, 100, Taiwan (ROC).
⁴ Department of Ophthalmology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1St Road, Sanmin Dist., Kaohsiung City, 80756, Taiwan (ROC).
⁵ School of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung City, 80708, Taiwan.
⁶ Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, No. 2, Yude Road, North District, Taichung City, 404327, Taiwan (ROC).
⁷ School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, Taichung City, 404333, Taiwan.
⁸ Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95, Wenchang Road, Shilin District, Taipei, 111045, Taiwan.
⁹ School of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City, 242062, Taiwan (ROC).
¹⁰ Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong District, Kaohsiung City, 833401, Taiwan.
¹¹ School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong Street, Beitou District, Taipei, 112304, Taiwan (ROC).
¹² Department of Ophthalmology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217, Taiwan.
¹³ Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, No.6, Sec. W., Jiapu Road, Puzi City, 613, Chiayi County, Taiwan (ROC).
¹⁴ Department of Ophthalmology, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City, 33302, Taiwan (ROC).
¹⁵ Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, No.2, Sec. W., Jiapu Road, Puzi City, 61363, Chiayi County, Taiwan (ROC).
¹⁶ School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City, 33302, Taiwan (ROC).
¹⁷ Department of Ophthalmology, Mackay Memorial Hospital, No. 92, Sec.2, Chung-Shan North Road, Taipei, Taiwan.
¹⁸ Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City, 100225, Taiwan (ROC). chyangoph@ntu.edu.tw.
¹⁹ Department of Ophthalmology, National Taiwan University College of Medicine, No. 1 Jen-Ai Road Section 1, Taipei, 100, Taiwan (ROC). chyangoph@ntu.edu.tw.

PMID: 37934385
PMCID: PMC10776529
DOI: 10.1007/s40123-023-00835-5

Literature- and Experience-Based Consensus for Acute Post-operative Endophthalmitis and Endogenous Endophthalmitis in Taiwan

Cheng-Yung Lee et al. Ophthalmol Ther. 2024 Jan.

. 2024 Jan;13(1):1-19.

doi: 10.1007/s40123-023-00835-5. Epub 2023 Nov 7.

Authors

Affiliations

¹ Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Hospital, No. 25, Ln. 442, Sec. 1, Jingguo Road, North District, Hsinchu City, 300, Taiwan (ROC).
² Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City, 100225, Taiwan (ROC).
³ Department of Ophthalmology, National Taiwan University College of Medicine, No. 1 Jen-Ai Road Section 1, Taipei, 100, Taiwan (ROC).
⁴ Department of Ophthalmology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1St Road, Sanmin Dist., Kaohsiung City, 80756, Taiwan (ROC).
⁵ School of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung City, 80708, Taiwan.
⁶ Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, No. 2, Yude Road, North District, Taichung City, 404327, Taiwan (ROC).
⁷ School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, Taichung City, 404333, Taiwan.
⁸ Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95, Wenchang Road, Shilin District, Taipei, 111045, Taiwan.
⁹ School of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City, 242062, Taiwan (ROC).
¹⁰ Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Road, Niaosong District, Kaohsiung City, 833401, Taiwan.
¹¹ School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong Street, Beitou District, Taipei, 112304, Taiwan (ROC).
¹² Department of Ophthalmology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217, Taiwan.
¹³ Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, No.6, Sec. W., Jiapu Road, Puzi City, 613, Chiayi County, Taiwan (ROC).
¹⁴ Department of Ophthalmology, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City, 33302, Taiwan (ROC).
¹⁵ Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, No.2, Sec. W., Jiapu Road, Puzi City, 61363, Chiayi County, Taiwan (ROC).
¹⁶ School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City, 33302, Taiwan (ROC).
¹⁷ Department of Ophthalmology, Mackay Memorial Hospital, No. 92, Sec.2, Chung-Shan North Road, Taipei, Taiwan.
¹⁸ Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan S. Road (Zhongshan S. Road), Zhongzheng District, Taipei City, 100225, Taiwan (ROC). chyangoph@ntu.edu.tw.
¹⁹ Department of Ophthalmology, National Taiwan University College of Medicine, No. 1 Jen-Ai Road Section 1, Taipei, 100, Taiwan (ROC). chyangoph@ntu.edu.tw.

PMID: 37934385
PMCID: PMC10776529
DOI: 10.1007/s40123-023-00835-5

Abstract

Clinical practices on acute post-operative and endogenous endophthalmitis (EnE) are highly variable among clinicians due to a lack of up-to-date, high-quality evidential support. An expert consensus is thus much needed. A panel consisting of ten retinal specialists in Taiwan was organized. They evaluated relevant literature and developed key questions regarding acute post-operative and EnE that are cardinal for practice but yet to have conclusive evidence. The panel then attempted to reach consensus on all the key questions accordingly. There were eight key questions proposed and their respective consensus statements were summarized as follows: Gram staining and culture are still the standard procedures for the diagnosis of endophthalmitis. Vitrectomy is recommended to be performed earlier than the timing proposed by the Endophthalmitis Vitrectomy Study (EVS). Routine intracameral antibiotic injection for post-cataract surgery endophthalmitis prophylaxis is not recommended because of potential compounding error hazards and a lack of support from high-quality studies. Routine fundus examination is recommended for all patients with pyogenic liver abscess. In EnE, vitrectomy is recommended if diffused and dense vitritis is present, or if the disease progresses. These consensus statements may work as handy guidance or reference for clinical practices of acute post-operative and EnE.

Keywords: Acute post-operative endophthalmitis; Endogenous endophthalmitis (EnE); Expert consensus; Taiwan.

PubMed Disclaimer

Conflict of interest statement

Cheng-Yung Lee, Shwu-Jiuan Sheu, San-Ni Chen, Cheng-Kuo Cheng, Hsi-Kung Kuo, De-Kuang Hwang, Chien-Hsiung Lai, Wei-Chun Chan, Yi-Ting Hsieh, and Chang-Hao Yang declare that they have no competing interests.

Figures

**Fig. 1**
Discrepancy between the presentations of anterior and posterior segments in endogenous endophthalmitis. In a case of pyogenic liver abscess-related endogenous Klebsiella endophthalmitis, the posterior segment revealed dense vitritis (**), massive sub-macular abscess (*) with diffused retinal vessel sheathing (A); while at the same time only mild hypopyon presented in the anterior chamber (*) (B)

See this image and copyright information in PMC

References

1. Keynan Y, Finkelman Y, Lagacé-Wiens P. The microbiology of endophthalmitis: global trends and a local perspective. Eur J Clin Microbiol Infect Dis. 2012;31(11):2879–2886. doi: 10.1007/s10096-012-1659-x. - DOI - PubMed
1. Sadiq MA, Hassan M, Agarwal A, Sarwar S, Toufeeq S, Soliman MK, et al. Endogenous endophthalmitis: diagnosis, management, and prognosis. J Ophthalmic Inflamm Infect. 2015;5(1):32. doi: 10.1186/s12348-015-0063-y. - DOI - PMC - PubMed
1. Muqit MM, Mehat M, Bunce C, Bainbridge JW. Early vitrectomy for exogenous endophthalmitis following surgery. Cochrane Database Syst Rev. 2022;11(11):Cd013760. - PMC - PubMed
1. Regan KA, Radhakrishnan NS, Hammer JD, Wilson BD, Gadkowski LB, Iyer SSR. Endogenous endophthalmitis: yield of the diagnostic evaluation. BMC Ophthalmol. 2020;20(1):138. doi: 10.1186/s12886-020-01418-9. - DOI - PMC - PubMed
1. Fileta JB, Scott IU, Flynn HW., Jr Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina. 2014;45(2):143–149. doi: 10.3928/23258160-20140306-08. - DOI - PubMed

LinkOut - more resources

Full Text Sources

[1] Keynan Y, Finkelman Y, Lagacé-Wiens P. The microbiology of endophthalmitis: global trends and a local perspective. Eur J Clin Microbiol Infect Dis. 2012;31(11):2879–2886. doi: 10.1007/s10096-012-1659-x. - DOI - PubMed

[2] Keynan Y, Finkelman Y, Lagacé-Wiens P. The microbiology of endophthalmitis: global trends and a local perspective. Eur J Clin Microbiol Infect Dis. 2012;31(11):2879–2886. doi: 10.1007/s10096-012-1659-x. - DOI - PubMed

[3] Sadiq MA, Hassan M, Agarwal A, Sarwar S, Toufeeq S, Soliman MK, et al. Endogenous endophthalmitis: diagnosis, management, and prognosis. J Ophthalmic Inflamm Infect. 2015;5(1):32. doi: 10.1186/s12348-015-0063-y. - DOI - PMC - PubMed

[4] Sadiq MA, Hassan M, Agarwal A, Sarwar S, Toufeeq S, Soliman MK, et al. Endogenous endophthalmitis: diagnosis, management, and prognosis. J Ophthalmic Inflamm Infect. 2015;5(1):32. doi: 10.1186/s12348-015-0063-y. - DOI - PMC - PubMed

[5] Muqit MM, Mehat M, Bunce C, Bainbridge JW. Early vitrectomy for exogenous endophthalmitis following surgery. Cochrane Database Syst Rev. 2022;11(11):Cd013760. - PMC - PubMed

[6] Muqit MM, Mehat M, Bunce C, Bainbridge JW. Early vitrectomy for exogenous endophthalmitis following surgery. Cochrane Database Syst Rev. 2022;11(11):Cd013760. - PMC - PubMed

[7] Regan KA, Radhakrishnan NS, Hammer JD, Wilson BD, Gadkowski LB, Iyer SSR. Endogenous endophthalmitis: yield of the diagnostic evaluation. BMC Ophthalmol. 2020;20(1):138. doi: 10.1186/s12886-020-01418-9. - DOI - PMC - PubMed

[8] Regan KA, Radhakrishnan NS, Hammer JD, Wilson BD, Gadkowski LB, Iyer SSR. Endogenous endophthalmitis: yield of the diagnostic evaluation. BMC Ophthalmol. 2020;20(1):138. doi: 10.1186/s12886-020-01418-9. - DOI - PMC - PubMed

[9] Fileta JB, Scott IU, Flynn HW., Jr Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina. 2014;45(2):143–149. doi: 10.3928/23258160-20140306-08. - DOI - PubMed

[10] Fileta JB, Scott IU, Flynn HW., Jr Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina. 2014;45(2):143–149. doi: 10.3928/23258160-20140306-08. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Literature- and Experience-Based Consensus for Acute Post-operative Endophthalmitis and Endogenous Endophthalmitis in Taiwan

Affiliations

Literature- and Experience-Based Consensus for Acute Post-operative Endophthalmitis and Endogenous Endophthalmitis in Taiwan

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

References

LinkOut - more resources

Full Text Sources

Abstract

Conflict of interest statement

Figures

Similar articles

References

Related information

LinkOut - more resources

Full Text Sources